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California Endowment: Nursing Diversity Intiative (NDI)

In 2004, The California Endowment's Nursing Diversity Initiative (NDI) contracted with NAM to boost health care workforce diversity in California's Central Valley, which is home to large and growing ethnic communities. Latinos, Asian and Pacific Islanders, African Americans and other ethnic groups comprise close to half the Central Valley's booming population, which now stands at 6.5 million.

Through a communications campaign and a series of brainstorming sessions and events, which brought together members of the ethnic media, health care experts, and education and community leaders, the campaign raised the visibility of California's nursing shortage crisis in ethnic communities and developed communications strategies to promote ethnic diversity in Central Valley health care workplaces.

At brainstorming sessions in Fresno and Stockton, the campaign convened 28 decision makers (including editors, publishers and marketing representatives) from 21 ethnic media outlets to discuss their potential role in recruiting readers and listeners into health care careers and in addressing California's nursing shortage in particular.

Participants agreed on the need to educate their audiences on the health care industry's labor crisis and the industry's need--especially in the Central Valley--for a multilingual, culturally competent workforce. To get their audiences interested in the topic, however, they stressed the importance of publicizing first-person stories from the field.

Toward this end, NAM partnered with the Health Professions Education Foundation to craft profiles of two nursing scholarship recipients: Valerie Xiong, a teacher who entered nursing because of her parents' negative experiences with the health care system, and Somjay Burkdoll, who entered nursing to support her family. Xiong's and Burkdoll's stories were featured in the participating ethnic media.

The campaign also paid ethnic media to run print ads, radio programming and web content. NAM and NDI focused the campaign message to promote a range of health care careers--not just nursing--as opportunities to serve their communities in a field with potential for professional growth.

"Plant a seed and watch your career in health care blossom," was the message in print ads that reached hundreds of thousands of readers in four different languages, targeting a broad range of ethnic communities: Khmer, Portuguese, Spanish, Vietnamese, Cambodian, Latino, Native American, Hmong, Laotian and African American.

Fourteen radio stations carried the same message in five languages (Hmong, Khmer, Laotian, Portuguese and Spanish), in spots produced by NAM. Inspired by the campaign, several radio stations--including Radio Canon, Radio Campesina, Univision Radio and Asian Broadcasting--also produced in-depth programs on nursing and health care, featuring interviews with health care professionals and advocates as well as listener call-in segments.

To direct its target audience to concrete resources, the campaign launched a website and toll-free number. With the help of the Coalition for Nursing Careers in California (CNCC), NAM created The site describes more than a dozen health careers, including nursing, occupational therapy, phlebotomy and radiology, in both English and Spanish. The site also directed visitors to two toll-free health career hotlines (one in English, one in Spanish), staffed by Central Valley Legal Services.

To add value to the campaign, NAM organized a series of events that opened communication between ethnic media and key decision makers, ranging from U.S. Surgeon General Richard Carmona to California Secretary of Health and Human Services Kim Belshe and former Institute of Rural Studies director Don Villarejo.

Goal: Increase diversity of the health care workforce in the Central Valley.

Impact: The campaign's communication efforts reached hundreds of thousands of ethnic community members with information on opportunities in the health care field, and audience response to the campaign yielded critical information on how best to attract a diverse health care workforce. Print ads ran in 21 publications with a combined circulation of more than half a million, including Spanish-language publications with a combined circulation of close to 300,000. Visits to the campaign website's English and Spanish pages spiked during the height of the campaign's advertising efforts. TCE learned from calls to the toll-free hotline (two-thirds of which were from Spanish speakers) that the biggest barrier to pursuing health careers was English language proficiency--important information that informed the initiative's ongoing strategy. As a result, many callers were referred to language schools as the first step toward a career in health.

Goal: Enhance the ethnic media's capacity and commitment to communicating health care messages to their audiences.

Impact: The campaign's brainstorming sessions, media briefings and other events promoted dialogue between ethnic media and the health care industry, giving the media access to new resources for covering health care issues. NAM put reporters in direct touch with nurses at a "Success Stories" luncheon and on radio call-in programs for Spanish, Hmong and Laotian audiences, which was key in helping ethnic media cover the nursing shortage and inform audiences about opportunities in health care. At NAM's EXPO and other events, reporters from the ethnic media strengthened their ties to community-based organizations and health advocates and gained access to high-profile health leaders, connections that will undoubtedly enhance their capacity to cover health issues into the future.